• Senior Risk & Compliance Analyst

    Highmark Health (Albany, NY)
    …**PREFERRED RESPONSIBILITIES** + Clinical operations analysis (monitors and analyzes medical management activities + Responsible for communicating review ... Senior Risk Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies,… more
    Highmark Health (07/04/25)
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  • Pharmacy Manager

    Walgreens (Bronx, NY)
    …accurately to prevent payment rejections. Resolves patient issues by working with insurance companies and medical providers and conducting or participating in ... generics, less expensive medicines, and over-the-counter products. Refers to the medical provider, as needed, to ensure medication is taken correctly, health… more
    Walgreens (08/31/25)
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  • Field Auditor 1 / Trainee 1/Trainee 2 (NY Helps)

    New York State Civil Service (New York, NY)
    NY HELP Yes Agency Insurance Fund, State Title Field Auditor 1 / Trainee 1/Trainee 2 (NY HELPS) Occupational Category Financial, Accounting, Auditing Salary Grade 18 ... Zip Code 10007 Duties Description The New York State Insurance Fund (NYSIF) provides Workers' Compensation Insurance ...provide records on their computer screen for the auditor's review or choose to have the review more
    New York State Civil Service (07/04/25)
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  • Licensed Practical Nurse, Acute Care Cooperstown…

    Bassett Healthcare (Cooperstown, NY)
    …offerings include: Paid time off, including company holidays, vacation, and sick time Medical , dental and vision insurance Life insurance and disability ... no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback Identifies and reports… more
    Bassett Healthcare (07/18/25)
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  • Utilization Manager Reviewer, RN (Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …with Provider Relations, explaining processes for accessing Health Plan to perform medical review , obtains case or disease management support, or otherwise ... external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case… more
    Excellus BlueCross BlueShield (08/23/25)
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  • LPN Care Coordinator - Cancer Center - Full Time

    Guthrie (Corning, NY)
    …Prior Authorization * *Collect necessary documentation and submit it to the patient's insurance company for review and determination of coverage of ordered ... and Outgoing * *Sick calls - collect data for review , assessment and instruction from RN or Provider *...patients Monitor and Manage Department in Basket * *E-Guthrie Medical Advice Requests * *Medication Cancellation notifications * *Electronic… more
    Guthrie (08/08/25)
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  • Manager of Capital Planning

    Regional Transit Service (Rochester, NY)
    …application and administration, and general compliance reviews with the FTA (Triennial Review ) and NYSDOT. The Manager of Capital Planning supports the development ... related to the National Environmental Policy Act (NEPA) and State Environmental Quality Review Act (SEQR). The Manager of Capital Planning oversees the Transit Asset… more
    Regional Transit Service (08/20/25)
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  • Physician - Pathologist

    Veterans Affairs, Veterans Health Administration (Syracuse, NY)
    …in multi-disciplinary conferences such as Tumor Board like Hempath Conference. Review appropriate clinical history/ medical record when responsible for autopsy ... Summary The Syracuse VA Medical Center is seeking a Pathologist to serve...401K with up to 5% in contributions by VA Insurance : Federal health/vision/dental/term life/long-term care (many federal insurance more
    Veterans Affairs, Veterans Health Administration (07/19/25)
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  • General Radiologist-Body Imaging- Prostate MRI

    Veterans Affairs, Veterans Health Administration (New York, NY)
    …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities The VA New York Harbor Healthcare ... System provides care to eligible Veterans via 3 medical centers and 2 community-based outpatient clinics. The Margaret Cochran VA Campus is a high complexity… more
    Veterans Affairs, Veterans Health Administration (07/05/25)
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  • Risk Adjustment Coding Specialist (Remote in New…

    CDPHP (Latham, NY)
    …Clinical Documentation Improvement preferred. + Demonstrated knowledge of medical record review and diagnosis coding within the health insurance industry. + ... coding of risk adjustment eligible members. This position will have responsibility for review of medical records to identify accurate ICD-10 diagnosis codes,… more
    CDPHP (08/27/25)
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